villitis of undetermined etiology (VUE): The
other, more common variety of chronic villitis is villitis
of undetermined etiology (VUE) which is marked by a
sub-total involvement of villi, >10% of villi being affected
signifying a severe degree of involvement. A chronic villitis
placenta does not usually look abnormal on casual gross inspection.
Some feel7 that the VUE reaction reflects
a graft-versus-host reaction with the inflammatory response
halting the maternal reaction against fetal antigens at the
level of the placenta. Mother tends not to be ill; and VUE
has been associated with recurrent reproductive failure, as well as abnormal nonstress testing18, IUGR18,
and mid-trimester elevations of maternal AFP18. Villi infiltrated by activated maternal T lymphocytes18. Vue with vasculitis/perivasculitis, fetal vascular occlusion, and downstream avascular terminal villi (obliterative fetal vasculopathy)18.

Future pregnancies (obstetrical view):

When there is a prominent degree of involvement,
there is an uncertain but known risk of VUE recurrence in subsequent
pregnancies7. Assuming that any treatable TORCH/luetic
infection was treated and resolved in the mother, recurrence of
the DSV variety is said to be rare.

Sequelae in the newborn (pediatric view):

In the case of the VUE variety, there is a relatively
infrequent association with TORCH/luetic etiology; therefore, any
newborn sequelae would be (as in the DSV variety) relative to any
actual such infection. If the VUE is extremely prominent and with
evidence of chronic vascular insufficiency (prominent villous edema;
significant erythroblastosis; newborn polycythemia) or association
with additional lesions suggesting subacute or chronic vascular
compromise, then sequelae are possible. Since IUGR can be seen
in both VUE and DSV varieties, when IUGR is present, possible sequelae
are at least related to the fact of IUGR.

If the newborn appears to have neurologic injury,
then management is by standard methods. If there is no apparent
abnormality, then care should be taken (all cases DSV; severe cases
VUE) that the baby is seen at typical and standard times throughout
childhood development in order to detect any milestone delays in
order to allow early corrective intervention should delays be encountered6.

It is too premature in our understanding of possible
sequelae to actually routinely discuss such risks with parents.

Salafia, Carolyn M., "Gross and Microscopic
Diagnosis of the Placenta: How to Do It and Its Clinical Revelance", American
Society of Clinical Pathologists Teleconference Series 1929, Session I,
Syllabus, pgs. 1-14; 9/14/90.